As we struggle these days to grasp the full implications of the election and the racism, sexism, and xenophobia, that it has unleashed it’s important to come together and to support each other and projects which respond to these challenges, which we hope you agree includes Women’s Equity in Access to Care and Treatment. WE-ACTx addresses global inequities and the HIV epidemic, especially for women and children.

Lessons Learned
I’ve learned from working with WE-ACTx in Rwanda for the past 13 years that the obstacles faced by women, children, and families with HIV in Kigali, Rwanda are relevant to each of us – their desire for respect, for accessible, free, high quality health care including reproductive rights, for free, universal, high quality education for all children, for secure housing, for enough to eat every day, to be safe from abuse and violence, and for the opportunities to earn a living and participate fully in their communities. And the contradictions I see in Kigali –where new, tall luxurious hotels and convention centers are being built, while the patients we have seen for 13 years still have no underwear — are related to the economic struggles and contradictions we see in our country.

So while the fight against global inequities in health care seems difficult and exhausting, (and lately has been less visible on the front pages of newspapers and on the airwaves) the only approach is to take the long view. Being part of the ‘60s and being a health care provider during the HIV/AIDS epidemic have reinforced for me how much we can do when we unite, make strong demands, follow the leadership of those most in need and oppressed, and don’t give up on making a better world.

The HIV epidemic affects gay men, people of color, sex workers, IV drug users and the most vulnerable in every community across the world. Working with Rwandan women’s groups and health care providers in Kigali, WE-ACTx For Hope, our Rwandan sister organization, has served over 3500 patients since opening the first clinic in July 2004. We have ensured integrated comprehensive medical and psychosocial care for women, men, children, and for over 400 youth and young adults. Since 2009, not a single infant has been born with HIV to any mother enrolled in our clinic. Youth friendly services including support groups, music therapy, yoga, vocational training and income generation have challenged the effects of trauma, poverty, stigma and loss that so many young people experience.

Taking Risks to Innovate
Your support has allowed the program to take risks, use innovative models, and make a real difference in the lives of the patients, health workers and the community. The clinic has implemented Rwanda’s Treat All Strategy: retesting all patients, providing special education classes at the initiation of therapy, starting everyone on antiretroviral therapy and monitoring, per WHO and U.S. recommendations. The clinic is instituting Rwanda’s Differentiated Service Delivery Model of ART allowing eligible patients with stable HIV on treatment to come for medical consultation every 6 months and pick up medications and have adherence counselling and support every 3 months instead of monthly. The clinic’s family assessment surveyed all parents/care-givers of 270 children under 18 years of age to identify factors which may reduce adherence to antiretroviral medication. Staff will conduct patient focus groups and develop strategies to address poverty, stigma, and family dysfunction.

Youth Support
I have been heartened by what seems like a galvanizing moment in our country, especially among young people. But I’m not surprised. I spend a lot of time with young medical students and house staff in Boston and I’m amazed at how many issues they care about and work on. I’ve also had the privilege of working with high school students from the Latin School in Chicago for many years now. Each year, under the direction of their teacher and organizer of international activities, Ingrid Dorer Fitzpatrick, they raise close to $15,000 to support a summer camp for 50 youngsters in Kigali. A group of students from Latin comes to Kigali and, as co-counselors with Rwandan youth leaders, bring hope and joy and tangible goodies to the campers.

Your Support
Finally, we are concerned about the reduction in funds from some of the other large donor organizations supporting WE-ACTx For Hope. Although they have successfully diversified their funding, the clinic still needs the security of feeling they are on firm ground in order to sustain the full service program they have designed. Please help us again this year so all the patients can move toward healthier and joyful lives.